Osteotomy
A normal knee has a straight axis, which means that the load on the leg passes through the middle of the knee. If the load axis of the leg deviates, resulting in O-legs or X-legs, a corrective procedure known as a knee osteotomy is the appropriate solution.
Causes
The leg axis can deviate from the normal alignment due to several reasons:
- Congenital axis defect Previous surgery (e.g., complete removal of the inner or outer meniscus)
- Previous accident resulting in a fracture that healed in an abnormal position.
Types
Leg axial deviation can occur in two directions:
- Bow leg or varus knee: The load axis runs through the inner part of the knee, leading to overload and faster cartilage wear on the inside of the knee.
- X-leg or valgus knee: The load axis runs through the outer part of the knee, leading to overload and faster cartilage wear on the outside of the knee.
Operation
Surgical correction of the axis deviation can be achieved through an open wedge or closed wedge osteotomy. This procedure helps protect the overloaded part of the knee against premature wear and tear or osteoarthritis. It’s important to note that this correction is beneficial only if the other parts or compartments of the knee are still in good condition.
- In an open wedge osteotomy, the bone is cut through with a saw and chisel, and then gradually spread open until the desired correction is achieved. The correction is monitored during the procedure using fluoroscopy.
- In a closed wedge osteotomy, a triangular wedge is removed, and the leg is folded. Open wedge corrections are more commonly performed, except in cases involving smokers and obese individuals, where closed wedge corrections are preferred.
3D Planning
The use of 3D planning allows for a detailed study of the axis deviation and precise execution of the correction. This technique is increasingly employed for both simple and complex corrections, including cases of malunion. Our service has developed a dedicated 3D analysis and execution platform, where we aim to remain at the forefront of patient-specific applications in osteotomy.
Frequently Asked Questions
This depends on the strength and coordination of your knee. Your physiotherapist can assess when participation in traffic is responsible again. Usually this is possible from week 6-8
This obviously depends on the type of work and can vary from 8 weeks to 6 months
Blood clotting and phlebitis may occur. If these clots break free, they can travel to the lungs and cause a life-threatening pulmonary embolism. To minimize this risk, injections with a blood thinner are therefore given for 30 days. Infections are rarely seen but can occur either around the wound or deeper around the plate. Superficial wound infections can in most cases be treated with antibiotics. Deep infections usually require additional surgery. Antibiotics are given during the procedure to minimize the risk of infection. Delayed healing of the osteotomy is more common in smokers and diabetics. Smoking cessation is therefore recommended for this type of procedure.